Inspection on 05/05/05 for Windmill Lodge

This inspection was carried out on 5th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Windmill Lodge 14/03/08

Windmill Lodge 26/07/06

Windmill Lodge 17/10/05

Windmill Lodge 30/11/04

Windmill Lodge 05/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Windmill Lodge 26 Springhead Road Northfleet Gravesend Kent DA11 9QY Lead Inspector Eamonn Kelly Unannounced 5, 6 & 9 May 2005 10:00 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Windmill Lodge Address 26 Springhead Road Northfleet Gravesend Kent DA11 9QY 01474 354212 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Abdoollah Hosanee Mr Abdoollah Hosanee Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 November 2004 Brief Description of the Service: Accommodation and care is provided for up to 8 people with learning and some physical disabilities. Twenty-four hour care is provided (a “sleep-in” member of staff is on duty at night). All service users have single en-suite bedrooms. There is a garden at the rear and a patio area at 1st floor level. The owner/manager is nurse trained (RNM and RNMH), has a diploma in management studies and has achieved the Registered Manager’s Award. The premises are about 15-20 minutes walk from the centre of Gravesend and there is easy access to public transport and to a range of amenities. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The first day was spent at the home where some records were checked and service users were met. On the second day, visits were made to a number of external locations meeting service users. Telephone contact was also made with an advocacy service representative with experience of working with clients at Windmill Lodge. Further meetings with service users took place on the 3rd day and the outcomes of meeting some service users at external locations were discussed with members of staff. What the service does well: What has improved since the last inspection? What they could do better: The service user’s care plan records should be fully up-to-date. The CSCI should be informed in writing of all notifiable issues and incidents. There should be better liaison between staff at the home and staff at locations where service users visit. The written information available to potential service users and their advocates should be improved to assist at initial placement stages. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 6 There should be a suitable number of trained and experienced members of staff at the home commensurate with the admissions policy and assessed needs of service users (including those likely to be admitted). Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Prospective service users and their advocates are unable to readily determine from written information and the prevailing policy of the home if their needs will be effectively met. The needs of current service users have been identified and are being met. EVIDENCE: The service user’s guide/statement of purpose does not adequately define the levels of physical disabilities for which a safe and effective service can be provided. An example is that the owner wishes to accommodate wheelchair users; access to the premises and the potential for service users to use wheelchairs within the premises may be restricted. New service users (and their advocates) are encouraged to visit, meet other service users and members of staff and get information about how their particular needs are likely to be met. All service users are provided with a personal contract that outlines their (and the home’s) rights and responsibilities. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6-9 Service users have a real say in how they spend their time and in deciding for example which locations they visit. They are supported in taking some risks as part of an independent lifestyle. However, there were minor shortfalls identified when service users were visited during the inspection at a number of external locations. EVIDENCE: The service user care plan process has been updated and individual care plans generally reflect circumstances seen during the inspection. In some cases, the actual circumstances were not accurately noted in these records. There was evidence that communication between the home’s staff and organisations where service users spend time during the day is improving (eg. planned meeting between the owner, WKAS worker, day centre staff and care manager to discuss perspectives on a particular service user’s care needs). The examples of recorded risk assessments seen corresponded to the circumstances witnessed during the inspection. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 The home provides a good range of opportunities for service users. There is a well researched “healthy eating” programme at the home. EVIDENCE: The pattern of activities of each service user was discussed and it was clear that opportunities commensurate with their assessed needs are identified. There was evidence that service users have a stable and planned set of routines. Two service users generally are under the supervision of persons outside the home during weekdays: 2 are retired and spend most of their time under the supervision of members of staff at home. One is independent and decides for himself how he wants to spend his day [often helping his friends outside the home, for which a written risk assessment has been produced]. The premises are about 15-20 minutes walk from the centre of Gravesend. Each service user has ready access with staff supervision (or, in some cases, unaccompanied) to a range of community amenities. There is a record of service users’ preferred locations and newer routines are added from time to time if they indicate new preferences that benefit their lifestyles and progress. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 11 The manager described how these alterations would occur following consultation with and comments from service users. Service users have the benefit of transport in the home’s minibus (supplemented if necessary by occasional use of cars owned by members of staff). There was evidence that service users have access to a range of leisure activities. In summer 2004, they went (accompanied by members of staff) for a weeklong holiday to Devon, which they helped to choose and plan. A service user outlined how a holiday was being planned for later in 2005. Service users currently pay for the main cost of the holiday (the cost of a weeklong holiday away from the home should be included in the basic weekly fee (Standard 14.4). The home’s intention is to enable service users to maintain their network of personal and family friends. Circumstances were discussed which indicated that routines of the home should not take precedence over this aspect of personal development and that if there were relevant issues that required restrictions these are specifically shown in the service user plan. Members of staff are aware that subtle guidance is sometimes needed to encourage service users to have varied and balanced meals. There was evidence that the home places a high emphasis on this and part of the home’s approach was witnessed during the inspection visits. There is a well researched “healthy eating” programme at the home. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Good support is provided for service users in relation to healthcare and physical and emotional needs. EVIDENCE: There was evidence that service users received sensitive personal support. The home has procedures about the provision of personal care by male and female carers to male and female service users. Service users have ready access to a GP, dentist, optician and other healthcare specialists. Members of staff described how any possible need for medical intervention (or specific staff supervision) is recognised in many cases by observation of small changes in service user’s demeanour. The home has a monitored dosage system of medication (Boots) and several MAR sheets were checked during the inspection visit. The MAR sheets were completed satisfactorily. Medication was stored safely and in an ordered way. A current edition of BNF was available to members of staff on duty. Current members of staff have received “accredited” training in medication administration. A day centre representative described how the home had helped a service user change to clothes which were “more relevant and age-related” and how close liaison was helping to have consistent practices at the home and day centre. A WKAS worker was involved in establishing and maintaining positive behavioural improvements. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 13 Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 &23 The home takes steps to protect service users and it has a complaints procedure. EVIDENCE: A précis of the current complaints procedure was displayed. The owner is reviewing the Adult Protection policy and procedures and has undertaken to advise the CSCI of the outcome of this review. Recruitment processes are sufficient in that the steps necessary (eg. references, CRB checks, POVA arrangements) are in place and followed. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 The premises are suitable for the needs of current service users. EVIDENCE: The premises were refurbished in 2004 (to meet National Minimum Standards) when the owner purchased it. The home is comfortable and safe for service users, staff and visitors (as far as can be reasonably determined). Each service user has a single bedroom (with en-suite facility) that meets service user’s current needs and lifestyles. Bedrooms are comfortable and well furnished. Each bedroom contains many of the service users’ personal possessions. There are sufficient WC and bathroom facilities (with a staff WC on the ground floor). Service users and members of staff have the use of a kitchen, 1st floor level patio area at the rear, dining area, lounge and rear garden. The premises were clean, tidy and free from offensive odours. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users current needs are met by appropriately trained staff but a full complement of trained staff should be in place to meet the needs of service users as defined in the revised service user’s guide/statement of purpose. EVIDENCE: The owner/manager has suitable qualifications in care and management. The senior support worker is undertaking NVQ Level 2 in Care. The other member of staff was at the point of leaving the home and the owner/manager is aware that he has yet to achieve a position where a stable workforce is in position to meet the needs of a full complement of service users. The needs of wheelchair users (if admitted) could also have an effect on the home’s staffing requirement. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 42 Service users benefit from a well run home. The management team have good qualifications and experience in management and care. There should be improved communication between the home and representatives of organisations where service users spend time and away from the supervision of staff at the home (to ensure that the care needs of service users are met by both parties). The safety and welfare of service users is promoted as a matter of priority. EVIDENCE: The owner/manager is registered with NMC (Nursing & Midwifery Council) as a registered nurse (RNM & RNMH). And he has wide experience in the care of people with learning & physical disabilities and those with mental health difficulties. He has a diploma in management studies, has achieved units in the Registered Manager’s Award and is undertaking a BSc in Health & Social Care. The assistant manager is completing NVQ Level 4 in Care (having completed a Certificate in Health and Social Care Practice). There has been good progress Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 18 in meeting the requirements and recommendations contained in the previous CSCI inspection report. There was some evidence that the home has a formal procedure in place for obtaining the views of family, friends and advocates of service users with results made available to staff, service users and others. However, there was evidence when service users were visited at their external locations that there were some shortfalls in communications between the home’s staff and daycare providers which had the potential to act to the detriment of service users. In relation to the promotion of safety and welfare of service users, the previous pre-inspection questionnaire contained a declaration relating to maintenance and associated records (with some declarations checked at the time). These indicated that: • • • • • • • • A fire safety officer visited in 2004 and all requirements were met. All fire safety requirements are attended to (eg. fire drills, fire alarm tests, emergency lighting checks, fire equipment checks). Portable appliance checks are in place (the owner completed a training course and obtained the equipment to now carry out these checks within the home in future). The first of bi-annual water checks (for Legionella) was undertaken. The electrical “hard-wiring” certificate was issued in May 2004. The requirements of the environmental health officer were met (visit in October 2004). The call alarm system was operational (but not used by any service users). COSHH standards are being met. Further improvements have been made to the premises since the previous inspection visit. The home has a file containing documentation relating to the above issues. There are two electrical circuit boards, one in the hall and one in the carer’s “sleep-in” room on the second floor. A number of LCD sensors have been placed throughout the premises to enable the source of any fire to be identified quickly from either location. The owner stated that service users are protected by appropriate insurance when being driven in the home’s minibus. Members of staff have identified deficiencies in the training offered by training providers for Moving & Handling and the owner is taking steps to provide more appropriate and effective training. All relevant incidents (notifiable under Regulation 37) should be forwarded to the CSCI within a reasonable period (ie. within 24 hours). Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Windmill Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 x 2 x x 3 x H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4&5 Requirement Prospective service users and their advocates must have the information they need to make an informed choice about where to live. Written notifications of all notifiable incidents should be made to the CSCI. Timescale for action 01/07/05 2. 42 37 01/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations The service users guide/statement of purpose should state clearly whether or not the home can care successfully for people with physical disabilities (eg. for wheelchair users). If the home wishes to admit a service user with such significant dependency needs, the owner/manager should not make such an admission without making an application for variation of the homes registration. There should be improved communication between the home and representatives of organisations where service users spend time and away from the supervision of staff at the home. The purposes of such placements and the advantages accrueing from them should be accurately noted in service users care plan records. H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 21 2. 6 & 39 Windmill Lodge 3. 35 There should be a suitable number of trained and experienced members of staff at the home commensurate with the admissions policy and procedure as outlined under the above Requirement 1 and Recommendation 1. 4. Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Windmill Lodge H56-H06 S59514 Windmill Lodge V224876 050505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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